Marisa Manley

The number of urgent care centers in the United States is growing, and many physicians see expansion into urgent care services as an opportunity to grow their practices. These tips explore what medical practices need to consider when expanding into urgent care, including real estate needs, gauging the market and competition, and how to conduct market research.

Many medical practices-from family care and pediatricians to orthopedic specialists- are looking into adding urgent care to the roster of services they offer.

With the growth in urgent care centers from 8,000 locations nationwide in 2008 to 9,300 in 2013, many physicians see such an expansion as an opportunity to grow their practices and increase their revenue.

What do practices need to consider when expanding into urgent care? Does it take more than just hanging out a new sign?

Here are several questions and tips practices should consider when exploring whether expansion into urgent care is the right move:

Determine if urgent care fits your practice

Decide whether you can and should devote space to providing urgent care service or convert the practice entirely into an urgent care practice. 

All in all, you need to be very clear about how the urgent care facility fits into the overall practice strategy before you commit and spend funds.

A primary care physician (PCP), pediatrician, or orthopedic surgical practice, for example, may elect to set up an urgent care service as an adjunct to the regular practice.  Emergency situations, such as an animal bite, can create a need for pediatric services on an urgent basis -waiting two weeks for an appointment is not an option during a medical emergency.

Plan for all costs of adding urgent care to an existing practice and facility. These may include adding space.

Consider what marketing efforts will be needed to inform the community of your new services. For instance, you’ll need to attract walk-in patients.  All of these changes and others imply additional costs.

Be realistic when assessing your facility needs

Assess facilities needs realistically, and understand how you expect to meet those needs.  If you decide to expand within an existing facility, you will likely need a separate entrance and waiting area. 

Patients waiting for a scheduled appointment will not be happy to see arriving patients receiving service before they do. As you expand, be aware of regulatory requirements that affect your build-out like permits or licenses for x-ray equipment.

Parking needs to be ample, convenient, and visible. If patients seeking urgent care must circle your parking lot to find a space, they will go elsewhere. A covered drop-off point may help.

Conduct thorough market research, study competition

Know and understand your market and the size of the area you will serve.  Gauge the public’s need for urgent care services in your area and the reasonable travel radius for patients to reach your practice. 

You may have a built-in market as patients seek to avoid waiting in emergency rooms, but be aware that with the recent rapid growth in urgent care, some markets may be saturated.  A new facility that opens on a major shopping strip may be the third or fourth urgent care operator in a four-mile stretch.  It’s a great location but could be doomed before it opens because of the competition.

Has a hospital established an urgent care center that will compete with you?  Will establishing your own urgent care center diminish the referrals you receive from pediatric, internal medicine, and family practices? 

Existing practices should see that you are not just a competitor but offer something different.  Review the hours your competitors operate and when you can offer supplemental coverage. 

So carefully research the local market conditions first. Determine the location of other urgent care centers through a market survey using professional real estate databases.

How will local laws and regulations affect your plans? 

An urgent care practice needs walk-in traffic. This requires a highly visible location with instantly recognizable signage.  Be aware of local signage ordinances and other restrictions that will limit your visibility. 

Other restrictions, laws, and regulations, such as parking restrictions, may be unfriendly to establishing new medical practices and services. So always check with your local planning department or other government agencies before beginning.

Many patients seeking urgent care want an alternative to hospital emergency rooms.  Others may have no primary care doctor and just want a quick way to treat a cold, fever, or sprain. 

Here are some questions to consider when  evaluating your facility:

Is your facility welcoming, clean and contemporary? 

Is the waiting area attractive with a soothing ambience? 

Do your patients feel comfortable-not too hot or too cold- in the exam room?

Is the front office designed to help your patients register quickly and easily and then leave your practice without needless complication? 

Remember, your patients having positive experiences in your space will be key to your future success.

Not every physician or group should jump on the urgent care bandwagon.  Following these steps will help you determine if it is the right move for your practice.

A successful urgent care facility must have the correct real estate platform in terms of size, location, functionality, visibility, and accessibility. 

If you’ve assessed the needs for urgent care in your market, gauged the competition, staffed with the best practitioners available and created a welcoming facility, urgent care can be a viable strategy for a new, independent practice or an expansion of your existing medical facility.

Marisa Manley is president of Healthcare Real Estate Advisors (HCREA) in New York, New York. Send your practice management questions to 

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The number of urgent care centers in the United States is growing, and many physicians see expansion into urgent care services as an opportunity to grow their practices.

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 My landlord offered my practice a lease renewal that included a "good guy guarantee." He said this provision would be to my advantage, but I am skeptical. It sounds like this type of provision protects the landlord, not the tenant. Any thoughts? 

 Under a good guy guarantee, if your business can no longer sustain its lease obligations, and you (1) vacate the space promptly, (2) leave the space clean, and (3) give the landlord the keys, then only the business that signed the lease will remain liable for the lease obligations. Your personal liability under the guarantee will end when you vacate the space.  

A "true" good guy guarantee benefits you, the tenant, because it creates a substantially reduced liability as compared to the more traditional personal guarantee, whereby your personal assets may be at risk to satisfy obligations if your practice were to default on the lease. 

 Beyond this, when negotiating terms of your lease, consider ways to avoid a guarantee entirely. Emphasize your practice's financial condition and consider negotiating a larger security deposit-possibly one that diminishes over time-as an alternative. 

 is president of Healthcare Real Estate Advisors in New York, New York. 

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